In a press release, NICE said “women whose lives are being affected by the symptoms of menopause should not feel they have to suffer in silence.” It notes that HRT is a treatment option for menopausal symptoms, yet over the last decade confusion over its safety has led to a decline in its use and variation in practice.
The guideline highlights that HRT is effective for treating several menopausal symptoms and recommends offering it for hot flushes and night sweats after discussing the risks and benefits. In addition, HRT is also considered a treatment option (as well as cognitive behavioural therapy) to alleviate low mood that arises as a result of menopause. A number of tables are included in the guideline to explain the risks of using HRT and confirm that HRT does not increase cardiovascular disease when started in women aged under 60 years, and it does not affect the risk of dying from cardiovascular disease. The guideline states that HRT is not associated with an increased risk of developing type 2 diabetes. Furthermore, oestrogen-only HRT has little or no increase in the risk of breast cancer. HRT with oestrogen and progestogen can be associated with an increase in the risk of breast cancer but any increase risk reduces after stopping HRT. Other treatment options NICE recommends include offering vaginal oestrogen to women with urogenital atrophy. Moisturisers and lubricants can also be used alone or in addition to vaginal oestrogen for vaginal dryness.